Cyclothymia (cyclothymic disorder)

Overview

Cyclothymia (sy-kloe-THIE-me-uh), also called cyclothymic disorder, is a rare mood disorder. Cyclothymia causes emotional ups and downs, but they're not as extreme as those in bipolar I or II disorder.

With cyclothymia, you experience periods when your mood noticeably shifts up and down from your baseline. You may feel on top of the world for a time, followed by a low period when you feel somewhat down. Between these cyclothymic highs and lows, you may feel stable and fine.

Although the highs and lows of cyclothymia are less extreme than those of bipolar disorder, it's critical to seek help managing these symptoms because they can interfere with your ability to function and increase your risk of bipolar I or II disorder.

Treatment options for cyclothymia include talk therapy (psychotherapy), medications and close, ongoing follow-up with your doctor.

Symptoms

Cyclothymia symptoms alternate between emotional highs and lows. The highs of cyclothymia include symptoms of an elevated mood (hypomanic symptoms). The lows consist of mild or moderate depressive symptoms.

Cyclothymia symptoms are similar to those of bipolar I or II disorder, but they're less severe. When you have cyclothymia, you can typically function in your daily life, though not always well. The unpredictable nature of your mood shifts may significantly disrupt your life because you never know how you're going to feel.

Hypomanic symptoms

Signs and symptoms of the highs of cyclothymia may include:

• An exaggerated feeling of happiness or well-being (euphoria)
• Extreme optimism
• Inflated self-esteem
• Talking more than usual
• Poor judgment that can result in risky behavior or unwise choices
• Racing thoughts
• Irritable or agitated behavior
• Excessive physical activity
• Increased drive to perform or achieve goals (sexual, work related or social)
• Decreased need for sleep
• Tendency to be easily distracted
• Inability to concentrate

Depressive symptoms

Signs and symptoms of the lows of cyclothymia may include:

• Feeling sad, hopeless or empty
• Tearfulness
• Irritability, especially in children and teenagers
• Loss of interest in activities once considered enjoyable
• Changes in weight
• Feelings of worthlessness or guilt
• Sleep problems
• Restlessness
• Fatigue or feeling slowed down
• Problems concentrating
• Thinking of death or suicide

When to see a doctor

If you have any symptoms of cyclothymia, seek medical help as soon as possible. Cyclothymia generally doesn't get better on its own. If you're reluctant to seek treatment, work up the courage to confide in someone who can help you take that first step.

If a loved one has symptoms of cyclothymia, talk openly and honestly with that person about your concerns. You can't force someone to seek professional help, but you can offer support and help find a qualified doctor or mental health provider.

Suicidal thoughts

Although suicidal thoughts might occur with cyclothymia, they're more likely to occur if you have bipolar I or II disorder. If you're considering suicide right now:

• Call 911 or your local emergency services number, or go to a hospital emergency department.
• Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

If you just can't make that call, reach out to someone else — immediately — such as your doctor, mental health provider, family member, friend or someone in your faith community.

Causes

It's not known specifically what causes cyclothymia. As with many mental health disorders, research shows that it may result from a combination of:

• Genetics, as cyclothymia tends to run in families
• Differences in the way the brain works, such as changes in the brain's neurobiology
• Environmental issues, such as traumatic experiences or prolonged periods of stress

Risk factors

Cyclothymia is thought to be relatively rare. But true estimates are hard to make because people may be undiagnosed or misdiagnosed as having other mood disorders, such as depression.

Cyclothymia typically starts during the teenage years or young adulthood. It affects about the same number of males and females.

Complications

If you have cyclothymia:

• Not treating it can result in significant emotional problems that affect every area of your life
• There is a high risk of later developing bipolar I or II disorder
• Substance misuse is common
• You may also have an anxiety disorder
• You may be at increased risk of suicidal thoughts and suicide

Prevention

There's no sure way to prevent cyclothymia. However, treatment at the earliest indication of a mental health disorder can help prevent cyclothymia from worsening. Long-term preventive treatment also can help prevent minor symptoms from becoming full-blown episodes of hypomania, mania or major depression.